{"package_id":"USCOURTS-cofc-1_13-vv-00956","decision_granule_id":"USCOURTS-cofc-1_13-vv-00956-1","petitioner_identifier":"R.B.","is_minor":1,"age_at_vaccination":12.27,"age_unit_raw":"years","vaccine_type":"HPV","vaccination_date":"2010-12-08","condition_raw":"anti-NMDA receptor encephalitis","condition_category":"encephalitis_encephalopathy","autism_spectrum_adjacent":1,"outcome":"compensated","award_amount_usd":null,"decision_date":"2017-05-03","extraction_version":"gemini-v2","extracted_at":"2026-04-30T02:44:20.739976+00:00","number_of_concurrent_vaccines":1,"dose_number":3,"time_to_onset_days":2,"theory_of_causation":"Petitioner R.B., a 12-year-old female, received the third dose of the HPV vaccine on December 8, 2010. Petitioner alleged that this vaccination caused anti-NMDA receptor encephalitis (ARE). Petitioner's experts, Dr. David J. Siegler (treating neurologist) and Dr. David Axelrod (immunologist), proposed that the HPV vaccine triggered a secondary immune response, potentially involving cytokine production leading to blood-brain barrier impairment and subsequent epitope spreading, which caused R.B.'s ARE. Dr. Siegler opined that R.B.'s condition showed a correlation to causation with the vaccine, citing a case study of ARE following other vaccines. Dr. Axelrod applied the Miller elements, arguing for a close temporal association, lack of alternative explanations, dechallenge, and biological plausibility, suggesting a secondary immune response occurring within days of vaccination. Respondent's expert, Dr. Mark P. Gorman (pediatric neuro-immunologist), argued that R.B.'s symptoms began before vaccination or too soon after for a vaccine link, and suggested alternative causes like a prior upper respiratory infection or alopecia areata. Dr. Gorman also contested the proposed mechanisms of molecular mimicry and epitope spreading. Special Master Brian H. Corcoran found that Petitioner met the three Althen prongs: (1) a legally probable medical theory, supported by Dr. Axelrod's proposed mechanisms and Dr. Siegler's treating physician opinion, despite challenges regarding specific scientific literature for epitope spreading; (2) a logical sequence of cause and effect, finding onset of severe symptoms two to three days post-vaccination consistent with a secondary immune response, supported by the Institute of Medicine's description of secondary responses and Dr. Siegler's discarding of alternative causes; and (3) a medically acceptable temporal relationship, aligning with the two-to-three-day onset. Respondent failed to prove an alternative cause. Petitioner was found entitled to compensation. Attorneys for Petitioner: Andrew Donald Downing. Attorneys for Respondent: Debra A. Filteau Begley. Decision Date: May 3, 2017.","is_death":0,"date_of_death":null,"petition_filed_date":"2017-02-22","case_summary":"On December 5, 2013, Leilah Al-Uffi filed a claim on behalf of her minor child, R.B., seeking compensation under the National Vaccine Injury Compensation Program. R.B. allegedly suffered from anti-NMDA receptor encephalitis (ARE) as a result of receiving the human papillomavirus (HPV) vaccine on December 8, 2010. Petitioner argued that R.B. experienced a secondary immune response to the vaccine, leading to the development of ARE. Respondent contended that R.B.'s symptoms began either before the vaccination or too soon after to be vaccine-related, and suggested alternative causes such as a prior upper respiratory infection or her history of alopecia areata. The Special Master found that Petitioner met the burden of proof for a non-Table claim, establishing a plausible medical theory, a logical sequence of cause and effect, and a medically acceptable temporal relationship between the vaccination and the onset of ARE. The court ruled that Petitioner was entitled to compensation, with damages to be determined in a separate order. Petitioner was represented by Andrew Donald Downing of Van Cott & Talamante PLLC, and Respondent was represented by Debra A. Filteau Begley of the U.S. Department of Justice. The decision was issued by Special Master Brian H. Corcoran.","is_minor_inferred":null,"is_pediatric_broad":1,"special_master":"Brian H. Corcoran","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Andrew Donald Downing","petitioner_attorney_firm":"Van Cott & Talamante PLLC","petitioner_attorney_location":"Phoenix, AZ","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|andrew-downing|","firm_canonical_key":"van-cott-and-talamante","package_title":"AL-UFFI et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_13-vv-00956","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_13-vv-00956.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_13-vv-00956.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_13-vv-00956-0","title":"AL-UFFI et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 09/30/2015) regarding 53 DECISION of Special Master - Interim Attorney's Fees. Signed by Special Master Brian H. Corcoran. 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SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 9/22/2017) Regarding 90 DECISION - Proffer (Signed by Special Master Brian H. Corcoran). (cr) Copy to parties.","date_issued":"2017-11-14","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_13-vv-00956/granules/USCOURTS-cofc-1_13-vv-00956-2/pdf","pdf_bytes":210737,"triage_decision":"keep","triage_reason":"docketText matches keep keyword ' proffer'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_13-vv-00956/USCOURTS-cofc-1_13-vv-00956-2"},{"granule_id":"USCOURTS-cofc-1_13-vv-00956-3","title":"AL-UFFI et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 10/17/2017) Regarding 95 DECISION of Special Master - Fees (Signed by Special Master Brian H. Corcoran). 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